Hesi compass B exit proctored exam
A male client who had a transurethral resection of the prostate (TURP) today has a continuous bladder irrigation (CBI). The client requests pain medication for abdominal pain rated at "9" on a scale of 0 to 10. Which action should the nurse take first?
Explanation & Rationale
A. Assisting him to ambulate may help relieve gas pain but is not appropriate until the cause of the abdominal pain is determined. B. Palpating the abdomen and checking urinary output is the priority because severe abdominal pain after TURP with CBI can indicate bladder distention from an obstruction in the catheter or tubing. Prompt assessment allows for timely intervention to prevent complications. C. Positioning on the left side and slowing the irrigation rate addresses discomfort from rapid infusion but should not be done without first assessing for blockage or retention. D. Administering PRN analgesics may mask symptoms without addressing a potentially urgent problem such as urinary obstruction.
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